Bench-to-bedside review: functional relationships between coagulation and the innate immune response and their respective roles in the pathogenesis of sepsis

Crit Care. 2003 Feb;7(1):23-38. doi: 10.1186/cc1854. Epub 2002 Dec 20.


The innate immune response system is designed to alert the host rapidly to the presence of an invasive microbial pathogen that has breached the integument of multicellular eukaryotic organisms. Microbial invasion poses an immediate threat to survival, and a vigorous defense response ensues in an effort to clear the pathogen from the internal milieu of the host. The innate immune system is able to eradicate many microbial pathogens directly, or innate immunity may indirectly facilitate the removal of pathogens by activation of specific elements of the adaptive immune response (cell-mediated and humoral immunity by T cells and B cells). The coagulation system has traditionally been viewed as an entirely separate system that has arisen to prevent or limit loss of blood volume and blood components following mechanical injury to the circulatory system. It is becoming increasingly clear that coagulation and innate immunity have coevolved from a common ancestral substrate early in eukaryotic development, and that these systems continue to function as a highly integrated unit for survival defense following tissue injury. The mechanisms by which these highly complex and coregulated defense strategies are linked together are the focus of the present review.

Publication types

  • Review

MeSH terms

  • Animals
  • Antithrombins / immunology
  • Blood Coagulation / immunology*
  • Blood Coagulation Factors / immunology
  • Drosophila Proteins*
  • Fibrinolysis / immunology
  • Horseshoe Crabs / immunology
  • Humans
  • Immunity, Innate / physiology*
  • Inflammation / blood
  • Inflammation / immunology
  • Lipoproteins / blood
  • Lipoproteins / immunology
  • Membrane Glycoproteins / immunology
  • Models, Animal
  • Receptors, Cell Surface / blood
  • Receptors, Cell Surface / immunology
  • Receptors, Interleukin-1 / immunology
  • Sepsis / immunology*
  • Thrombosis / blood
  • Thrombosis / immunology
  • Toll-Like Receptors


  • Antithrombins
  • Blood Coagulation Factors
  • Drosophila Proteins
  • Lipoproteins
  • Membrane Glycoproteins
  • Receptors, Cell Surface
  • Receptors, Interleukin-1
  • Toll-Like Receptors
  • activated protein C receptor
  • lipoprotein-associated coagulation inhibitor